Spectrum of Brain Abnormalities on Computed Tomography in Children with Cerebral Palsy

Open Access

Abstract

Introduction: Cerebral palsy (CP) is the most common cause of physical disability in childhood, and neuroimaging plays a crucial role in understanding its etiology. Computed tomography (CT) remains an accessible imaging modality in resource-limited settings. Objective: To evaluate the spectrum of brain abnormalities on CT in children with cerebral palsy and correlate findings with clinical subtypes. Methods & Materials: This cross-sectional study was conducted in the Department of Pediatric Neurology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from July 2009 to July 2010. A total of 81 children aged 0-12 years with confirmed cerebral palsy underwent non-contrast CT brain imaging. CT findings were classified and correlated with clinical subtypes. Data were analyzed using SPSS version 12.5, with the chi-square test used for association (p<0.05 significant).Results: Among 81 children, 52 (64.2%) were male, with a mean age of 4.7 ± 2.8 years. Spastic cerebral palsy was predominant (84.0%), with quadriplegia being the most common subtype (38.3%). Abnormal CT findings were observed in 62 (76.5%) children. Cerebral atrophy was the most frequent abnormality (25.9%), followed by ventricular dilatation (22.2%) and periventricular leukomalacia (18.5%). Significant correlations were found between specific findings and CP subtypes: periventricular leukomalacia with spastic diplegia (54.5%), encephalomalacia with spastic hemiplegia (60.0%), and basal ganglia lesions with dyskinetic CP (71.4%) (p<0.001). Normal CT scans were observed in 19 (23.5%) children, predominantly in ataxic and hypotonic subtypes. Conclusions: CT brain abnormalities are present in 76.5% of children with CP, with significant correlations between imaging patterns and clinical subtypes. CT remains a valuable diagnostic tool in resource-limited settings, though normal scans in certain subtypes warrant further evaluation with MRI when available.